针灸联合推拿治疗椎动脉型颈椎病的Meta分析  

Randomized Controlled Trails of Acupuncture and Massage Therapy for Cervical Spondylosis of Vertebral Artery Type: A Meta-analysis

作　　者：王丽[1] 韦丹[2,3] 刘一然[2,3] 李佳[1] 余乐[2,3] 黄伟[2,3] 张艳佶 周仲瑜[2,3] WANG Li;WEI Dan;LIU Yi-ran;LI Jia;YU Le;HUANG Wei;ZHANG Yan-ji;ZHOU Zhong-yu(Hubei University of Chinese Medicine,Hubei,Wuhan 430061,China;Hubei Provincial Hospital of TCM,Hubei,Wuhan 430061;Hubei Institute of TCM,Hubei 430074,China)

机构地区：[1]湖北中医药大学,武汉430065 [2]湖北省中医院,武汉430061 [3]湖北省中医药研究院,武汉430074

出　　处：《中国中医基础医学杂志》2018年第9期1283-1286,1329,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：热层析新方法用于经络理论和针灸机理的研究(2012YQ16020303)

摘　　要：目的:系统评价针灸联合推拿治疗椎动脉型颈椎病的临床疗效。方法:电子检索中国知网(CNKI)、万方医学网(Wan Fang)、维普数据库(vip)和Pub Med,收集针灸联合推拿治疗椎动脉型颈椎病的随机对照试验(RCT),经过文献筛选后采用Rev Man5.3软件进行Meta分析。结果:共纳入11篇RCT患者共1086例。Meta分析结果表明,针推并用疗法治疗椎动脉型颈椎病效果优于单纯针灸和西药,差异有统计学意义[总有效率:OR=5.45,95%CI(3.50,8.51),Z=7.48,P<0.00001];与单纯针刺比较,针灸联合推拿在改善基底动脉血流方面有优势[基底动脉血流速度:OR=4.11,95%CI(2.97,5.25),Z=7.07,P<0.00001]。结论:证据表明,针推并用治疗椎动脉型颈椎病有一定优势,由于纳入文献数量较少,质量偏低,存在发表偏倚等,研究证据强度不够,今后仍需开展大样本、多中心、高质量的随机对照试验以做深入研究。Objective： To systematically assess the clinical efficacy of acupuncture combined with massage therapy in treatment for cervical spondylosis of vertebral artery type. Methods： Randomized controlled trials（ RCTs） involving acupuncture and massage for cervical spondylosis of vertebral artery type were confirmed from CNKI,Wan Fang Data,VIP databases and Pub Med,screened the trials which meet the criteria. Then,data analysis was performed by Rev Man 5. 3 software. Results： A total of 11 RCT trials involving 1086 patients were included. Meta analyses showed that treatment of cervical spondylosis of vertebral artery type by acupuncture and massage therapy is significantly superior to single acupuncture and Western Medicine[total effective rate： OR = 5. 45,95% CI（ 3. 50,8. 51）,Z = 7. 48,P 0. 00001].Compared with single acupuncture,acupuncture combined with massage therapy have advantages in improving the blood flow of basilar artery[blood flow velocity in basilar artery： OR = 4. 11,95% CI（ 2. 97,5. 25）,Z = 7. 07,P 0. 00001].Conclusion： Evidence shows that acupuncture and massage therapy have certain advantages in the treatment for cervical spondylosis of vertebral artery type. However,the evidence is not strong enough due to the research includes low quantity and quality trials, publication bias, etc. Large sample, multicenter, high-quality randomized controlled trials of acupuncture and massage for cervical spondylosis of vertebral artery type are necessary to further confirm the effect.

关 键 词：椎动脉型颈椎病 针灸疗法 推拿疗法 META分析 随机对照试验 

分 类 号：R245.31[医药卫生—针灸推拿学]